Severin Bohdan Palydowycz, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

191941-1 Issued in PA

Practice address

396 Route 6 and 209 Ste 1
Milford, PA 18337-9490

Phone

(570) 296-9696

Fax

(570) 409-0316

NPI assigned

Jun 1, 2005

Last updated

Dec 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 16

Medicare fee-for-service enrollment

Enrolled in NY, PA, NJ3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Ophthalmology

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tri State Eye Ophthalmology of Middletown PCGroup PAC ID 3476443995, 4 clinicians

Tri-State Eye IncGroup PAC ID 9335126291, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bon Secours Community Hospital Hospital, Port Jervis, NY, CCN 330135

Merit-based Incentive Payment System (MIPS)

Final score

93.21 of 100Reported as group

Quality

100

Improvement activities

40

Cost

77.37

Merit-based Incentive Payment System (MIPS)

Final score

92.69 of 100Reported as group

Quality

100

Improvement activities

40

Cost

75.64

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: spalydowycz@mtse1907.srs-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tri-State Eye Inc

  • Ophthalmology Physician
  • Milford, PA
  • NPI 1255450581

  NJ, NY

  Medicare reassignment Care Compare group NPD Authorized official
• Tri State Eye Ophthalmology of Middletown PC

  • Specialist
  • Middletown, NY
  • NPI 1053430256

  NJ

  Medicare reassignment Care Compare group NPD Authorized official
• Mandes R. Kates, MD, PLLC

  dba Warwick Eye Center

  • Ophthalmology Physician
  • Warwick, NY
  • NPI 1811173594
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bon Secours Community Hospital

  • General Acute Care Hospital
  • Port Jervis, NY
  • NPI 1659360709
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1215939483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 ROUTE 6 AND 209 STE 1",
            "city": "MILFORD",
            "state": "PA",
            "postal_code": "183379490",
            "telephone_number": "570-296-9696",
            "fax_number": "570-409-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 ROUTE 6 AND 209 STE 1",
            "city": "MILFORD",
            "state": "PA",
            "postal_code": "183379490",
            "telephone_number": "570-296-9696",
            "fax_number": "570-409-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALYDOWYCZ",
        "first_name": "SEVERIN",
        "middle_name": "BOHDAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "191941-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COALITION",
            "identifier": "306039037",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI/HMO",
            "identifier": "13950",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP OF NY",
            "identifier": "OX144P",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC/RAILROAD MEDICARE",
            "identifier": "180015253",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BLUE SHIELD",
            "identifier": "735048",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01406142 8",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY HEALTH 65",
            "identifier": "080558",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA USHC",
            "identifier": "527007",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHS",
            "identifier": "0D5215",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1404543",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "177141",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "1124972",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "15551",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY BLUESHIELD",
            "identifier": "70H321",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9784602",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P378882",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Alisson O'Donohue, PTA
• Dawn O'Keeffe, LCSW
• Kim O'Toole
• Gwendolyn Marie Oliver, P.T.A
• Natasha Pacholec, CCC-SLP
• Rikesh Patel
• Rita Pecoriello, PT
• Pediatric Practices of Northeastern PA
• Peerless Medical Inc (Drug 123)
• Marilyn Pena

• Specialist in Milford, PA
• Providers in Milford, PA by specialty
• Specialist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.